Non-Communicable Diseases Watch
May 2017
Move More and Sit Less
Key Messages
※
Insufficient physical activity is one of the 10 leading risk factors for death worldwide.
Regardless of physical activity level, higher total or prolonged sitting time can increase the risk
for a number of chronic diseases, including cardiovascular disease, type 2 diabetes and
some cancers.
※
In Hong Kong, about one-quarter of community-dwelling people aged 18-64 have inadequate
aerobic physical activity cum high sitting time. For children and adolescents, less than one-tenth
of them are active enough.
※
For optimal health, adults are encouraged to do at least 150 minutes of moderate-intensity aerobic
physical activity, or at least 75 minutes of vigorous-intensity aerobic physical activity, or
equivalent amounts throughout the week. Besides, they should minimise the amount of time
spent being sedentary (sitting) and break up long periods of sitting as often as possible.
※
For school-age children, active living can enhance fitness and help improve academic achievement.
Children and adolescents aged 5-17 years should accumulate daily at least 60 minutes of
moderate- to vigorous-intensity aerobic physical activity. To nurture healthy active kids, parents
and carers should act as good role model by being physically active.
※
For more information about the benefits of physical activity, physical activity guidelines or
tips on how to incorporate physical activity into daily life, please visit the Department of Health’s
“Change for Health” website http://www.change4health.gov.hk.
This publication is produced by the Surveillance and Epidemiology Branch, Centre for Health Protection of the Department of Health
18/F Wu Chung House, 213 Queen’s Road East, Wan Chai, Hong Kong http://www.chp.gov.hk All rights reserved
Non-Communicable Diseases Watch May 2017
Move More and Sit Less
Insufficient physical activity is one of the 10
leading risk factors for death worldwide. When
carried out on a regular basis and reaching adequate
levels, however, physical activity reduces the risk
of several chronic diseases and all-cause mortality.
Despite the fact that physical activity brings health
benefits, globally around 1 in 4 adults is not
active enough; more than 80% of adolescents
aged 11-17 are insufficiently physically active.1
Equally important, many people spend too much
of their waking time sitting or doing other
sedentary activities, either for work or recreation.2, 3
Emerging evidence suggests that too much sitting,
as distinct from too little physical activity, would
compromise cardiovascular and metabolic health.4, 5
Regardless of physical activity level, higher total or
prolonged sitting time are associated with increased
risks for cardiovascular disease incidence and
mortality, cancer incidence and mortality, type 2
diabetes incidence, metabolic syndrome incidence,
as well as all-cause mortality.6, 7
Recommendations on Physical Activity
and Sedentary Time
For optimal health, the World Health Organization
(WHO) recommends adults to do at least 150
minutes of moderate-intensity aerobic physical
activity (such as brisk walking, yoga, swimming or
cycling leisurely), or at least 75 minutes of vigorousintensity aerobic physical activity (such as jogging,
aerobic dance, fast swimming or cycling), or equivalent amounts throughout the week. For children and
adolescents aged 5-17 years, they should accumulate
daily at least 60 minutes of moderate- to vigorousintensity aerobic physical activity.1
In contrast with physical activity, no agreed
guidelines exist for sedentary time.2, 8 However, one
meta-analysis found that breaks in sedentary time
(e.g. light walking for a minimum of 1 minute)
might have positive effect on glycaemic control.9
Accordingly, some overseas health authorities issued
sedentary behaviour guidelines, asking children,
adolescents and adults to “minimise the amount of
time spent being sedentary (sitting) for extended
periods” and/or “break up long periods of sitting
as often as possible”.10-12 Of note, smart phones and
electronic screen products are gaining in popularity
and the age of use is getting younger. As prolonged
screen time displaces physical activities or outdoor
activities among children and youth, the Canadian
Sedentary Behaviour Guidelines also specify that
children and youth should limit their screen time,
and the less is the better.11
How Physically Active Hong Kong People
Are
In Hong Kong, data from the Behavioural Risk
Factor Surveys showed that over half of communitydwelling people aged 18-64 failed to attain the
WHO‟s recommended level of aerobic physical
activity for adults. In addition, more than one-third
of them sat 480 minutes (8 hours) or more per day
on average on a weekday (i.e. Monday to Friday).
Overall, about one-quarter of community-dwelling
people aged 18-64 had inadequate aerobic physical
activity and high sitting time (i.e. sitting 480 minutes
or more per day on average) (Figure 1).13
For children and adolescents, the Physical Fitness
Test for the Community coordinated by the Leisure
and Cultural Services Department in 2011/12
observed that less than one-tenth of them (8.3% for
children aged 7-12 and 8.4% for adolescents aged
13-19) had accumulated at least 60 minutes of
moderate or above intensity physical activity every
day in a week before enumeration. While about 40%
of the children reported that they had spent
more than 5 hours per day on sedentary activities
(including study and recreation) after school, over
one-quarter (25.7%) of adolescents spent an average
of 3 hours or more each day watching electronic
screens (including watching television, using cell
phones or computers, or playing video games).14
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Non-Communicable Diseases Watch May 2017
Figure 1: Level of physical activity among community-dwelling people aged 18-64, 2004-2016
Base: All respondents excluding ‘unknown’ and ‘outliers’ (such as those with sitting time <10 or >900 minutes per day on
average on a weekday) in respective survey.
Source: Behavioural Risk Factor Surveys, Department of Health.
Be Physically Active and Insert Breaks in Sedentary Time
Regular physical activity throughout the life course
enables people to live better, healthier and longer.
There are many ways to increase physical activity,
whether it is at home, at school, at work or in the
community. For most adults, just 30 minutes of
moderate- to vigorous-intensity physical activity a
day would give benefits to their brain, heart, lungs,
muscles and bones. While the benefits of physical
activity are not restricted to competitive sports or
exercise in a gym, three bouts of at least 10 minutes
each mini-workout can be as effective as one bout
of 30 minutes. Below are some general tips of
how to make time and opportunity for more physical
activities:
●
●
●
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Get up 30 minutes early in the morning and
do some exercises, such as jogging, swimming
and rope jumping.
Use 10-15 minutes of lunch-time for a brisk walk.
As prolonged sitting harms health, here are some tips
for limiting chair-time and incorporating stand-ups
and small walks into daily routines:
●
●
●
●
●
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Stand on bus, train or tram instead of sitting.
Stand or pace around while watching television or
during each commercial break.
Stand up while folding laundry, ironing or performing other sit-down tasks.
Stand up and pace around while talking on the
phone.
Hand-deliver messages to colleagues rather than
use the phone or emails, if possible in the workplace.
Stand and walk around the room when waiting for
meetings to start. Take a stand and stretch break
during meetings.
Go for a walk with family or friends after dinner.
Get off the bus, train or tram one or a few stops
early and walk the rest of the route.
Choose the stairs over the lift or elevator.
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Non-Communicable Diseases Watch May 2017
Childhood is an important age period for establishing
a habit of regular physical activity which may persist
into adulthood. For school-age children, active living
can enhance fitness and help improve academic
achievement.15 To nurture healthy active kids, here
are some ways parents and carers can do:
●
●
●
●
●
●
●
Act as good role model by being physically
active.
Provide children guidance on how to start and
educate them on how much physical activity
they need each day.
Give children toys and gifts that promote physical
activity, such as skipping ropes, bikes, balls and
rackets.
Show interest in the sports that they like, and
play with them.
Motivate children to be physically active with
praises.
Bring children to playgrounds, parks or beaches
more often.
Set limits on screen-time for recreation purpose,
especially during daytime.
For people suffering from chronic diseases and
those who have not exercised in the past or for a
while, a “stepwise” approach is advisable. People
in need can consult their family doctor and obtain a
proper, safe and personalised exercise prescription.
For more information about the benefits of physical
activity, physical activity guidelines or tips on how
to incorporate physical activity into daily life, please
visit the Department of Health’s “Change for Health”
website http://www.change4health.gov.hk. To enable
members of the public to perform physical activity
anytime and anywhere, DH has also produced a “10minute Exercise” video. Public can view the video at
https://www.youtube.com/watch?v=DoI6vWNy4uc.
References
1. Physical Activity. Geneva: World Health Organization, June 2016.
2. Bauman A, Ainsworth BE, Sallis JF, et al. The descriptive
epidemiology of sitting. A 20-country comparison using the International Physical Activity Questionnaire (IPAQ). Am J Prev Med
2011; 41(2):228-35.
3. Bennie JA, Chau JY, van der Ploeg HP, et al. The prevalence and
correlates of sitting in European adults - a comparison of 32
Eurobarometer-participating countries. Int J Behav Nutr Phys Act
2013; 10:107.
4. Owen N, Healy GN, Matthews CE, Dunstan DW. Too much
sitting: the population health science of sedentary behavior.
Exerc Sport Sci Rev 2010; 38(3):105-13.
5. Tremblay MS, Colley RC, Saunders TJ, et al. Physiological and
health implications of a sedentary lifestyle. Appl Physiol Nutr
Metab 2010; 35(6):725-40.
6. Biswas A, Oh PI, Faulkner GE, et al. Sedentary time and its
association with risk for disease incidence, mortality, and hospitalization in adults: a systematic review and meta-analysis. Ann Intern
Med 2015; 162(2):123-32.
7. Honda T, Chen S, Yonemoto K, et al. Sedentary bout durations
and metabolic syndrome among working adults: a prospective
cohort study. BMC Public Health 2016; 16:888.
8. Chau JY, Grunseit AC, Chey T, et al. Daily sitting time and
all-cause mortality: a meta-analysis. PLoS One 2013;
8(11):e80000.
9. Chastin SF, Egerton T, Leask C, Stamatakis E. Meta-analysis of
the relationship between breaks in sedentary behavior and
cardiometabolic health. Obesity (Silver Spring) 2015; 23(9):
1800-10.
10. Canadian Sedentary Behaviour Guidelines. Ottawa, Ontario:
Canadian Society for Exercise Physiology, 2011.
11. Start Active, Stay Active. A Report on Physical Activity for Health
from the Four Home Countries' Chief Medical Officers. London:
Department of Health, 2011.
12. Australian's Physical Activity and Sedentary Behaviour Guidelines. Canberra, ACT: Australian Government Department
of Health, 2014.
13. Behavioural Risk Factor Surveillance System. Hong Kong SAR:
Department of Health.
14. Healthy Exercise for All campaign. Physical Fitness Test for
the Community. Key Findings. Hong Kong SAR: Leisure and
Cultural Services Department, 2012.
15. The Association between School-based Physical Activity,
including Physical Education, and Academic Performance.
Atlanta, GA: Centers for Disease Control and Prevention, U.S.
Department of Health and Human Services 2010.
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Non-Communicable Diseases Watch May 2017
World Family Doctor Day 2017
World Family Doctor Day (WFDD) is celebrated
every year on 19 May to highlight the contribution
of family doctors in health care systems around
the world.
To echo WFDD 2017, the Primary Care Office (PCO)
of the Department of Health (DH) launched the
“Thank You Doc!” campaign in February 2017 to
invite the public to show their gratitude towards
their family doctors. Participants are encouraged to
take creative photo(s) to express their thankfulness
and send to PCO via email. By the deadline of
31 March 2017, over 100 photos were received. A heart-shaped collage is compiled here to
thank all who have contributed. The photos will be used in publicity materials to promote
WFDD 2017.
To instill the concept of family doctor to families with
children, PCO of DH also designed a new poster with the
English slogan “My Family Doctor Walks with Me”.
The poster includes the drawing of a family and their family
doctor by a 6 year-old girl. The smiling faces tell us that
they enjoy a good relationship. This is indeed a showcase of
WFDD - a real life patient and her family acknowledging the
importance of their family doctor in maintaining their health.
Join us in recognising the role of family doctors as your health
partner! Please visit www.familydoctor.gov.hk to find a family
doctor that suits your need if you have not got one.
Editor-in-Chief
Non-Communicable Diseases (NCD) WATCH is dedicated to
Dr Regina CHING
promote public’s awareness of and disseminate health information
Members
about non-communicable diseases and related issues, and the
importance of their prevention and control. It is also an indication of
Dr Thomas CHUNG
Dr Ruby LEE
our commitments in responsive risk communication and to address
Dr Cecilia FAN
Mr YH LEE
Dr Anne FUNG
Dr Albert NG
Ms Janice HO
Dr Eddy NG
Dr Rita HO
Dr Lilian WAN
Dr Karen LEE
Dr Monica WONG
the growing non-communicable disease threats to the health of our
community. The Editorial Board welcomes your views and comments.
Please send all comments and/or questions to [email protected].
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